CHIMEHERB人工皮临床应用研究总结

CHIMEHERB人工皮是由海洋生物材料制成的烧伤创面覆盖材料,主要成分是甲壳胺(chi-tosan).经山东省13所医院在不同类型的烧伤创面,历时3年的临床应用496例表明:CHIMEHERB人工皮对烧伤创面有良好地促进愈合作用,适用于新鲜Ⅲ°创面、供皮区创面、深Ⅱ°削痂创面、脱痂创面以及部分切痂植皮创面.不适于感染严重的烧伤创面.该人工皮不致敏,无刺激,无吸收中毒之虞,虽然弹性与粘附性还不理想,但不失为我国目前较完好的一种创面覆盖物.     

CHIMEHERB人工皮使用的体会

从1989年4月～1990年10月,我科在69例病人中使用CHIMEHERB人工皮,覆盖治疗了供皮区,Ⅱ°烧伤创面、脱痂创面的残余肉芽创面.临床应用表明:CHIMEHERB人工皮能加快创面的愈合,是目前较好的一种创面覆盖物,用人工皮覆盖创面2～3天后,人工皮干燥,不需再换药,可减轻病人的痛苦.     

烧伤病人中应用CHIMEHERB人工皮的临床研究

1989年4月～1990年10月期间,由全国组成的临床研究组10个烧伤单位对CHIMEHERB人工皮进行全面临床研究.研究目的是:(1)探索应用方法.(2)明确适应症.(3)评价疗效.在260例烧伤病人中,共应用365个不同类型创面,有效率为90.5％,其中优良率为79.7％.研究指出,CHIMEHERB人工皮的性能适合于作为暂时性创面覆盖物,对上皮生长具有有利影响,未发现占位和排斥现象,以及过敏和其他不良反应.主要适用于(1)供皮区,(2)Ⅱ°烧伤创面.(3)深Ⅲ°烧伤脱痂和削痂创面.(4)网状植皮和小皮片(或条状)植皮创面。(5)残余肉芽创面.亦可用于切痂创面.但不适于深Ⅱ°新鲜创面和切痂嵌皮.感染创面应用CHIMEHERB人工皮应结合抗感染措施.应用人工皮创面需良好包扎与固定.人工皮下渗出物多需引流.     

人工皮在烧伤创面的应用

16例烧伤病人应用CHIMEHERB人工皮覆盖26个创面,其中浅Ⅱ°及部分深Ⅱ°创面11个,深Ⅲ°削痂创面10个,切削痂覆盖自体网状皮创面5个,与辐照猪皮对照观察,临床获得较好效果.认为在有效的清创及正确的创面处理下覆盖人工皮能减少创面渗出,有利创面愈合.作为一种新型的生物性敷料,无同种异体皮或异种皮移植时的排异现象,但其本身不具抗菌能力.     

烧伤病人应用CHIMEHERB人工皮的临床评价

本研究初步评价CHIMEHERB人工皮的治疗效果.74例,105个创面应用人工皮:供皮区47个创面,愈合时间平均为9±1.94d(天),油纱布对照为11.7±1.93d(P<0.01);14个浅Ⅱ°新鲜创面,70％在3～5d内逐渐干燥与创面紧密粘附,平均愈合时间为9.8±3.09d;11个存留上皮组织的削痂深Ⅱ°创面,平均5.7±1.7d干燥,平均愈合时间为10.55±3.09d,不需植自体皮;8个削痂刨面至脂肪组织或切痂创面4～9d更植自体皮,其存活率近乎100％,2个创面因残留坏死组织而失败;人工皮应用于16个自体皮间隙创面,除三个网状植皮和一个条状植皮创面失败外,所植自体皮都在人工皮下扩展融合,未观察到占位现象;对后期残余小创面有良好的效果.本研究结果提示人工皮对创面愈合具有有利影响.主要适用于供皮区、浅Ⅱ°新鲜创面、深Ⅱ°脱痂和削痂后存留上皮组织较多的创面、自体皮间隙创面和后期残余小创面,不适宜于深Ⅲ°新鲜创面.     

CHIMEHERB人工皮治疗烧伤临床总结

用青岛海洋大学生物材料研究所研制、海威生物材料有限公司生产的CHIMEHERB人工皮治疗烧伤50例.其中用于切、削痂创面10例,Ⅲ°创面20例,肉芽创面12例,供皮区创面3例.削痂创面一次覆盖面积最大23％,切痂创面13％.人工皮下可移植点状小皮片,亦可移植微粒皮,是一种较好的覆盖创面的生物材料.治疗浅Ⅱ°烧伤可使创面愈合时间提前2～4d(天);用于深Ⅱ°创面愈合时间为19～21d.人工皮治疗Ⅱ°创面,最大贴敷面积为60％.它对烧伤肉芽创面有促进周围上皮生长加速创面愈合的作用.     

CHIMEHERB人工皮在烧伤治疗中的应用

应用CHIMEHERB人工皮治疗烧伤病人125例.疗效观察表明,该人工皮具有与创面粘附牢固,减少创面水、电解质和蛋白质的丢失,减轻疼痛,促进上皮生长等功能.无排斥反应,存用方便和成本低廉.临床与生化检验证实,CHIMEHERB人工皮对肝肾功能无不良影响.适用于浅度烧伤创面、供皮区创面,及中、小面积深度烧伤的切、削痂创面.     

甲壳胺人工皮临床应用初步观察

使用甲壳胺人工皮复盖Ⅱ°烧伤新鲜创面,深Ⅱ°及Ⅲ°削切痂创面,供皮区创面共20例、25个创面,发现有减少创面渗出,减少疼痛,减少换药次数,节省敷料,防止加深,比传统方法提前2～3d(天)治愈的优点.     

CHIMEHERB人工皮的临床研究

22例临床应用研究的结果表明,人工皮最佳适应证是浅Ⅱ°烧伤、供皮区创面,亦能用于烧伤残余肉穿小创面.一旦克服早期粘附性差,抗感染能力差后,将可能大面积Ⅲ°烧伤切痂后的良好覆盖物,目前尚不适宜在混合移植中替代异体皮或异种猪皮.     

应用CHIMEHERB人工皮覆盖网状植皮创面

应用CHIMEHERB人工皮覆盖烧伤切(削)痂后自体网状植皮创面30例、44个创面,每例平均应用体表面积为5.22％,网状皮扩展比例为1:3.结果有明显积液者5个创面(11.36);感染3个创面(6.82％);需要补植皮创面4个(9.1％).人工皮具有良好的透气性和透湿性,可给创面造成无菌的内环境,未观察到过敏反应和排异现象,贮藏不需特殊设备,使用方便,具有人工皮所要求的基本特性,作为自体网状植皮表层覆盖物,可取得良好效果,值得临床推广应用.     

Microbial Biomass and Organic Nutrients in the Deep-Sea Sediments of the Central Indian Ocean Basin

In order to assess the impact of deep-sea mining on the in situ benthic life, we measured the microbial standing stock and concentration of organic nutrients in the deep-sea sediments of the Central Indian Ocean Basin in the Indian pioneer area. Sediments were collected using box core and grab samples during September 1996. The total bacterial numbers ranged from 10 10 -10 11 cells per g -1 dry weight sediment. There was a marginal decrease in the number of bacteria from surface to 30 cm depth, though the subsurface section registered a higher number than did the surface. The highest numbers were encountered at depths of 4-8 cm. The retrievable number of bacteria were two orders less in comparison with the direct total counts of bacteria. An almost homogeneous distribution of bacteria, total organic carbon, living biomass, and lipids throughout the depth of cores indicates active microbial and benthic processes in the deep sea sediments. On the other hand, a uniform distribution of total counts of bacteria, carbohydrates, and total organic carbon in all the cores indicates their stable nature and suggests that they can serve as useful parameters for long-term monitoring of the area after the benthic disturbance. Further studies on temporal variability in this region would not only verify the observed norms of distribution of these variables but would also help to understand restabilization processes after the simulated benthic disturbance.     

海上大直径钢管桩打桩过程中桩周土强度弱化研究

海上大直径钢管桩打桩过程中,桩周土体受到强烈扰动而发生强度弱化,掌握桩周土体强度弱化规律对于准确预测打桩过程、保证工程安全具有重要意义。为研究土体强度弱化规律,开展了环剪试验模拟打桩对桩周土体的扰动,测试土体强度随剪切速率的变化规律,建立了描述土体强度弱化规律的拟合公式,引入到打桩分析软件中。研究结果表明：土体的强度折减程度不仅与土体本身的性质有关还受到土体的埋深和剪切速率的影响,埋深越深土体强度折减程度越低,剪切速率越高土体强度折减越高,在打桩分析中可采用这里推荐的线性折减方法来模拟不同深度处土体强度的折减规律。     

Geoacoustic Inversion via Genetic Algorithm and Its Application to Manganese Sediment Identification

An acoustic inversion method using a wide-band signal and two near field receivers is proposed and applied to multiple layered seabed models including a manganese sediment. The inversion problem can be formulated into a probabilistic model comprised of signals, a forward model, and additive noise. The forward model simulates wide-band signals, such as chirp signals, and is chosen to be the source-waveletconvolution plane wave modeling method. The wavelet matching technique, using weighted least-squares fitting, estimates the sediment sound-speed and thickness on which determination of the possible numerical ranges for a priori uniform distribution is based. The genetic algorithm is applied to a global optimization problem to find a maximum a posteriori solution for determined a priori search space. Here the object function is defined by an L 2 norm of the difference between measured and modeled signals. Not only the marginal pdf but also its statistics are calculated by numerical evaluation of integrals using the samples selected during importance sampling process of the genetic algorithm.     

A Review of Some Environmental Issues Affecting Marine Mining

This article reviews information recently available from existing marine and coastal mining for responses to environmental issues affecting marine mining at different depths. It is particularly but not exclusively concerned with those issues affecting seabed biodiversity impact and recovery. Much information has been gathered in the past 10 years from shallow mining operations for construction aggregate, diamonds, and gold, from coastal mines discharging tailings to shallow and deep water, and from experimental deep mining tests. The responses to issues identified are summarized in a series of eight tables intended to facilitate site-specific consideration. Since impacts can spread widely in the surface mixing layer SML, and can affect the biologically productive euphotic zone, the main issues considered arise from the depth of mining relative to the SML of the sea. Where mining is below the SML, the issue is whether it is environmentally better to bring the extraction products to the surface vessel for processing (and waste discharge), or to process the extraction products as much as possible on the seabed. Responses to the issues need to be sitespecific, and dependent on adequate preoperational environmental impact and recovery prediction. For deep tailings disposal from a surface vessel, there are four important environmental unknowns: (1) the possible growth of "marine snow" (bacterial flocs) utilizing the enormous quantities of fine tailings particles (hundreds or thousands of metric tons per day) as nuclei for growth, (2) the possibility that local keystone plankton and nekton species may migrate diurnally down to and beyond the depth of deep discharge and hence be subjected to tailings impact at depth, (3) the burrow-up capability of deep benthos and their ability to survive high rates of tailings deposition, and (4) the pattern and rate of dispersion of a tailings density current through the deep water column from discharge point to seabed. Actions to obtain relevant information in general and site-specifically are suggested.     

Increased Particle Fluxes at the INDEX Site Attributable to Simulated Benthic Disturbance

Particle fluxes were measured 7 m above the sea bottom during the predisturbance, disturbance, and postdisturbance periods by using time series sediment traps attached to seven deep-sea moorings deployed in the INDEX experiment site in the Central Indian Basin. The predisturbance particle fluxes varied between 22.3 to 55.1 mg m -2 day -1 . Increased and variable particle fluxes were recorded by the sediment traps during the disturbance period. The increase observed was 0.5 to 4 times more than the background predisturbance fluxes. The increases in particle fluxes (~4 times) recorded by the sediment trap located in the southwestern direction (DMS-1) were the greatest, which could be the result of preferential movement of resuspended particles generated during the deep-sea benthic disturbance along the general current direction prevailing in this area during the experimental period. Also, the traps located closer to the disturbance area recorded greater fluxes than did the traps far away, across the Deep Sea Sediment Resuspension System path. This variability in recorded particle fluxes by the traps around the disturbance area clearly indicates that physical characteristics such as grain size and density of the resuspended particles produced during the disturbance had an important effect on particle movement. The postdisturbance measurements during ~5 days showed a reduction in particle fluxes of ~50%, indicating rapid particle settlement.     

Determination of In Situ Sediment Shear Strength from Advanced Piston Corer Pullout Forces

The advanced piston corer (APC) has been used by the Ocean Drilling Program since 1985 for recovering soft sediments from the ocean floor. The pullout force measured on extracting the core barrel from the sediment is shown to correlate with the average shear strength of the sediment core measured in the ship's laboratory. A simple rule of thumb is derived relating the shear strength of the sediment to the pullout force. Multiple APC holes at individual sites allow the consistency of the pullout measurements to be assessed. The effects of different operational procedures during APC coring are also explored. Although generally applicable, the correlation between pullout force and laboratory measurements of shear strength breaks down for some APC holes, possibly because of the disturbance of some sediment types during the APC coring process. A better understanding of the physical process of APC coring, and its effect on the properties of the sediment both inside and immediately outside the core barrel, would indicate what confidence can be put on the measurement of pullout force as a way of evaluating the in situ shear strength of deep sea sediments.     

Phylogenetic diversity and phenotypic characterization of cultivable bacterioplankton isolated from polar oceans

A set of 27 marine planktonic bacteria isolated from the polar regions was characterized by 16S rDNA sequencing and physiological and biochemical testing. More than half of these bacteria were positive for caseinase, gelatinase and 13-glucosidase, and could utilize glucose, maltose or malic acid as carbon source for cell growth. Twelve isolates expressed nitrate reduction activities. Except for one antarctic isolate BSwlO175 belonging to Actinobacteria phylum, these isolates were classified as γ-Proteobacteria, suggesting that γ-Proteobacteria dominated in cultivable marine bacterioplankton at both poles. Genus Pseudoalteromonas was the predominant group in the Chukchi Sea and the Bering Sea, and genus ShewaneUa dominated in cultivable bacterioplankton in the Prydz Bay. With sequence similarities above 97%, genus Psychrobacter was found at both poles. These 27 isolates were psychrotolerant, and significant 16S rDNA sequence similarities were found not only between arctic and antarctic marine bacteria （ 〉 99% ）, but also between polar marine bacteria and bacteria from other aquatic environments （ ≥ 98.8% ）, including temperate ocean, deep sea, pond and lake, suggesting that in the polar oceans less temperature-sensitive bacteria may be cosmopolitan and have a bipolar, even global, distribution at the species level.     

Deep-Sea Sediment Compression Curves: Some Controlling Factors, Spurious Overconsolidation, Predictions, and Geophysical Reproduction

Oedometer tests have been carried out on 70 undisturbed surficial clays (at approximately 250 mm below the mudline), mostly collected by free-fall corers from sites widely scattered throughout the deep-sea North Atlantic. Acoustic measurements were also made, initially on contiguous samples and ultimately on the same sample using a geophysically instrumented oedometer which also collected electrical resistivity data. Apart from those quiescent areas below the carbonate compensation depth, such as north of the West Indies where very fine clays exist, most of the samples are silty clays whose geotechnical-geophysical properties are dependent on the type of clay minerals present (and their ability to take in moisture), the sand-size fraction, and the quantity of carbonate present. Thus the pure clays have high compressibilities which decrease on the addition of coarse particles, while the converse is true for the acoustic parameters, these increasing with the sand fraction. Using the notion of the intrinsic compression line for all samples, and comparison to it of the measured compression curves, it is clear that, contrary to some previously held ideas, most deep-sea clays are normally consolidated; the addition of carbonate has the effect of creating an open, stronger sediment skeleton. Interestingly, where information is available, the variation with depth of a sample's acoustic velocity follows the void ratio pressure relationship of the compression curve. This allows the construction of an in-situ sediment compression curve using the in-situ geophysical observations.